We're still working in somewhat of an evidence vacuum, but based on the available data, I continue to believe that there are circumstances where colloids remain necessary. Until I see compelling evidence that challenges long-standing clinical practice—practice that has delivered consistently good outcomes and is supported by numerous prospective randomized controlled trials—I won't be convinced to change. When that evidence emerges, I'll be happy to adapt, but for now, I still see a role for colloids. My name is Professor Monty Mythen, and I'm a Professor of Anaesthesia and Critical Care at University College London. My lecture today focused on fluid restriction in the perioperative environment, exploring the important question: "How low can we go?" If we accept that fluid restriction may be in the patient's best interest, we must determine just how far we can safely push that boundary. This morning, I participated in two fantastic sessions. The second was a lively debate on the types of crystalloid solutions we use—specifically, the ongoing comparison between 0.9% sodium chloride (saline) and balanced solutions like Lactated Ringer's or Hartmann's. While we had an insightful exchange, the takeaway was clear: there are no definitive clinical outcome studies that demonstrate a clear benefit for either solution. Pragmatically, balanced solutions still appear to be the sensible choice, but the field is awaiting more robust trial results before drawing final conclusions. So far, no benefit has been shown for 0.9% saline, but it remains an open question. The IFAD conference is, in my view, the definitive international event on intravenous fluid therapy. It brings together leading experts and enthusiastic clinicians to discuss everything from types of fluids to fluid delivery strategies. The congress is exceptionally well-structured, and its engagement with social media and interactive elements place it at the very forefront of global critical care meetings. It's a true privilege to be part of it.

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